Individual provider Active NPI

Clinton Permenter, M.D.

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1083146963
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33069 Issued in OK
Practice address
4502 E 41St St
Tulsa, OK 74135-2536
Phone
(918) 579-2367
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33069 OK Primary

Addresses

Primary practice location

4502 E 41St St
Tulsa, OK 74135-2536

Mailing address

4502 E 41St St
Tulsa, OK 74135-2536
Phone (918) 579-2367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200831000923 TX Practitioner - Emergency Medicine 4183995095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

111 Dallas St
San Antonio, TX 78205-1201
Phone (210) 297-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33069OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients

Locations

20171 Chasewood Park Dr
Houston, TX 77070
Phone (713) 355-1000

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

4500 E Sam Houston Pkwy S
Ste 235
Pasadena, TX 77505

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

3515 Rayford Rd
Spring, TX 77386
Phone (832) 510-6576

1317 Lake Pointe Pkwy
Sugar Land, TX 77478
Phone (281) 277-1101

17400 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-4055

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083146963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-579-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-579-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERMENTER",
        "first_name": "CLINTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-09-11",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "33069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.